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2013, Number 2

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Rev Cub Med Int Emerg 2013; 12 (2)

The application of two prognostic scoring systems: TISS-28 and SEGRAV-23

Urrutia MO, Torres MA, Cruz PD, Sánchez SA

Language: Spanish
References: 22
Page: 57-69
PDF size: 356.20 Kb.


ABSTRACT

Introduction: The severity of patients in the pediatric intensive care unit (PICU) is an extremely important task to be evaluated for all the staff involved.
Objective: To apply TISS-28 score and SEGRAV-23 and evaluate the utility of both systems.
Methods: A descriptive and transversal study of 604 patients admitted to the PICU since 2007-2011 were conducted. All diagnostic and therapeutic interventions referred were registered.
Results: There was a slight predominance of males (58.28%), mainly in the group of 10-14 years. A predominance of patients under 5 years was observed. The largest number of patients had a length of stay of 3-10 days (78.48%) with a mortality of 0.84%, while those who stayed for a shorter time showed a higher mortality (20%). The patients admitted from the Emergency Department have a lower mortality (48.18%) than those coming from other hospitals (7.84%). Complicated pneumonia, electrolyte and acid-base disorders and sepsis were the commonest entities registered.
Conclusions: The SEGRAV-23 allowed the classification of patients in serious, very serious and critical, which was effective for assessing the severity of the patients, while the TISS-28 does not predict the prognosis of patients but represents a significant score to assess the workload of the medical and nursing staff.


REFERENCES

  1. Glance LG, Osler TM, Dick A. Rating the quality of intensive care units: is it a function of the intensive care unit scoring system? Crit Care Med 2009; 30 (9): 2145-6.

  2. Timsit JF, Fosse JP, Troche G, Alberti C, Chaval C, Chevret S, for the outcome study group, France. Calibration and discrimination by daily logistic organ failure assessment scoring for predicting hospital mortality in critically ill patients. Crit Care Med. 2008; 30(9):2151.

  3. Arabi Y, Haddad S, Al Maliks. Assessment of performance of tour mortality prediction systems in a Saudi Arabian intensive care unit. Crit Care Med. 2002; 6(2): 166-74.

  4. Vázquez Mata G, Jiménez M, Rivera Fernández R, Bravo M, Zimmerman J, Knaws W. Objetivación de la gravedad mediante el sistema APACHE II aplicado en España. Arch Bronconeumol. 2002; 39(56):217-22.

  5. Pearson GA, Shan F. Calibration of the pediatric index of mortality in Pediatric intensive care units. Arch Dis Child. 2001; 84:125-8.

  6. Macin JP, Pollack M. Review of methodologies and applications of scoring system in neonatal and pediatric intensive care. Pediatric Crit Care Med. 2000;1 (1):20-7.

  7. Dennis RJ, Pérez A, Rowan K, Londoño D, Gómez C. Factores asociados con la mortalidad hospitalaria en pacientes admitidos en cuidados intensivos en Colombia. Arch Bronconeumol. 2002; 38(7):117-22.

  8. Cullen DJ, Avetta JM, Briggs B. Therapeutic intervention scoring system. A method for quantitative composition of patient care. Crit Care Med. 1994; 56:20-4.

  9. Vincent JL, Moreno R. Clinical review: Scoring system in the critically ill. Critical Care Medicine. 2010; 14:207.

  10. Dahhan T, Jamil M, Al Tarifi. Validation of the APACHE IV scoring system in the patients with severe sepsis and comparison with the APACHE II system. Critical Care Medicine. 2009; 13(1):511.

  11. Urrutia Mora O. Sistema para Evaluar la Gravedad de los pacientes en Unidades de Cuidados Intensivos. IV Congreso Internacional de Urgencias y Emergencias. URGRAV 2006. [CD ROM]. La Habana: Desoft s.a.; 2006

  12. Cervantes del Ángel M. Uso de recursos y su correlación con la gravedad de la enfermedad en terapia intensiva. Revista de la Asociación Mexicana de Medicina Crítica y Terapia Intensiva. 2007; XXI (4):165-9.

  13. Oliveros H, Heliodoro F, Lobelo R. Recursos utilizados y calidad de vida de los pacientes críticamente enfermos egresados de la Unidad de Cuidados Intensivos. Acta Médica Colombiana. 2008; 33(4):26-278.

  14. Rubiano S, Oliveros H, Celis E. Mortalidad, estancia y uso de recursos en1622 pacientes provenientes de 19 Unidades de Cuidados Intensivos Colombianas. Acta Médica Colombiana Intensiva. 2007; 9:75-81.

  15. Peña Quijada A, Pardo Núñez A. Evaluación del pronóstico de mortalidad por los índices de gravedad del APACHE II y IV. Acta Médica. 2012; 1:25-33.

  16. Zimmerman JE, Kramer A. Acute Physiology and Chronic Health Evaluation APACHE IV: Hospital mortality assessment for today’s critically ill patients. Critical Care Medicine. 2007; 34(5):1297-310.

  17. Savastano L, Benito O, Cremaschir F. Análisis de la mortalidad en la Unidad de Cuidados Intensivos del Hospital Central de Mendoza, Argentina. Revista Médica Universitaria. 2009; 5(3):73-95.

  18. Monserrat Rué M, Roque Figolsa M, Mestre Saurab J, Artigas Raventós A. Mortalidad y estancia hospitalaria ajustados por gravedad como indicadores de efectividad y eficiencia de la atención a pacientes en estado crítico. Med Clin Bar. 2006; 313(2):486-91.

  19. Niederman MS, Mandell LA, Anzueto A, Bass JB. Guidelines for the management of patients with community-acquired pneumonia, diagnosis, assessment of severity, antimicrobial therapy and prevention. Am J Respir Crit Care Med. 2007; 163:1730-54.

  20. Martin Greg, Mannino DM, Eaton Stephanie, Moss Marc. The epidemiology of sepsis in the United States from 1979 through 2000. New England Journal of Medicine. 2008; 348(16):125-38.

  21. García Delgado M, Rivera Fernández R, Ruiz R, Navarrette Navarro P, Vázquez Mata G. Análisis de mortalidad en una unidad de cuidados intensivos neurotraumatológica según el sistema APACHE III. Med Clin Barc. 2001; 117(12):446-51.

  22. Fernández JB, Sánchez Echaniz J, Mintegui Raso S, Vázquez Ronco MA. Avances en medicina pediátrica de urgencia. An Esp Pediatr. 2000; 50:91-6.




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